Nipple-areolar complex (NAC) composite grafts in the Management of macromastia: Review of complications

Background: The free graft of the nipple-areolar complex is almost like a "composite" graft. This is because the skin of the areola and especially the nipple are usually thicker than the case is in the usual full-thickness skin grafts (FTSG). In traditional breast reductions, the nipple-areolar complex is located to its new position by means of pedicle flaps. This, of course, enhances the proper healing of the nipple-areolar complex (NAC). However, in the case of gigantic breast hypertrophies, it is often not possible to carry the NAC on the long pedicle flap. The NAC is therefore grafted as a free graft. Very often these grafts get infected or simple become necrotic and part or whole of them may be lost.
Material and methods : Fifteen Free Graft NAC were done for 8 patients in 5 years 1997-2001 .. The results are analysed.
Results Out of fifteen (15) free grafted NAC for eight (8) patients the following results were achieved: The factors underlying the total or partial loss of this composite graft may be numerous and are critically analyzed in this paper.

Keywords
Nipple-areolar complex (NAC), Macromastia, Composite graft, Complications